House Staff Involvement Is Key to Quality Efforts

It only takes one person to start a ball rolling down a hill. At hospitals, especially teaching hospitals, every member of the house staff (including resident physicians like myself) can be a tremendous engine for change.

That’s why my fellow resident physician, Dr. Adam Evans, and I founded the Housestaff Quality Council (HQC) here at New York–Presbyterian Hospital. It’s one of the nation’s first programs centered exclusively on helping house staff work with hospital leaders to influence, and ultimately improve, the quality of the patient care we deliver.

Because house staff directly provide so much of our care, it makes good sense to empower these individuals and allow them to make a difference in quality and safety efforts.

Even before we formed the council, it was clear that the integration of patient safety and quality into our everyday operations was becoming a very hot topic, and held importance for a lot of our staff and leaders. That, in turn, was driving a trend: A lot of people wanted to become leaders in quality, and it was just a matter of finding them. Creating the HQC allowed us to do that.

When you engage house staff and ask them for their input, you produce a solution that people are more likely to adopt. At New York–Presbyterian, residents, faculty advisors, nurses, pharmacists, and other members of the HQC meet regularly to discuss areas for improvement and map out strategies to effect change. We also work with our leaders to improve institution-wide procedures and policies around things like effective communication, infection prevention, and surgical and prescription safety.

For us, the effort started small and gradually grew. We began with one meeting. We got some food in the room. We got people away from their clinical duties, and invited them to come and talk with us about quality and safety challenges. Slowly but surely, we found our allies and grew our membership.

This is just the beginning. Now that we have unlocked the power of our house staff, there is no telling what we can accomplish. We can’t wait to find out what the future holds.

Peter M. Fleischut, MD, is an assistant professor of anesthesiology at Weill Cornell Medical College and a deputy quality and patient safety officer at New York–Presbyterian Hospital. He can be reached at pmf9003@med.cornell.edu.

0 thoughts on “House Staff Involvement Is Key to Quality Efforts”

It has been said before – I wish I could remember by whom – that residents live on the “fault lines” of the healthcare system and must give voice to the issues they witness there. Congrats to Dr. Fleischut and his colleagues for beginning this important work. Penn State has recently formed a resident Quality Council as well. All teaching hospitals should do the same!